中西医结合治疗布鲁氏菌病的效果研究

Study on the effect of integrated traditional Chinese and western medicine in the treatment of brucellosis

目的观察中西医结合治疗布鲁氏菌病临床效果及对体液免疫指标的影响。方法于2019年10月,以天津市第二人民医院收治住院的布鲁氏菌病患者169例作为研究对象,按照随机数字法分为两组,中西医结合治疗组84例,西医治疗组85例。西医治疗组给予抗菌素等常规西医支持治疗。中西医结合治疗组在西医治疗组基础上给予中医辨证施治的中药,6周为1疗程。对比两组患者治疗后临床疗效、中医证候积分,分析治疗前后患者体液免疫指标、生化及肝肾功能变化。结果中西医结合治疗组总有效率为100.00%(84/84),西医治疗组为97.65%(83/85),差异无统计学意义(P>0.05)。两组患者治疗前中医证候积分差异无统计学意义(P>0.05),治疗后中医证候积分均低于治疗前(P<0.05),其中中西医结合治疗组中医证候积分低于西医治疗组(P<0.05)。两组患者治疗前IgG、IgA、IgM、C3、C4、miRNA-155、C-反应蛋白(CRP)、红细胞沉降率(ESR)、谷丙转氨酶(ALT)和谷草转氨酶(AST)差异均无统计学意义(P>0.05);治疗后IgG、IgA、IgM、miRNA-155、CRP、ESR、ALT和AST均低于治疗前,C3和C4补体水平高于治疗前(P<0.05),其中中西医结合治疗组IgG、IgA、IgM、miRNA-155、CRP、ESR、ALT和AST均低于西医治疗组,而C3和C4补体水平高于西医治疗组(P<0.05)。结论中西医结合治疗布鲁氏菌病可以明显改善中医证候积分,同时降低CRP和ESR水平,其作用机制可能与调节患者体液免疫指标有关。

Objective To observe the clinical effect of integrated traditional Chinese and western medicine on brucellosis and its influence on humoral immune indexes.Methods In October 2019,169 cases of brucellosis hospitalized in Tianjin Second People's Hospital were selected as the research objects,and divided into two groups according to the random number method,84 cases in the integrated treatment group and 85 cases in the western medicine treatment group.The western medicine treatment group was given antibiotics and other routine western medicine support treatment.The integrated treatment group was given traditional Chinese medicine for treatment based on syndrome differentiation,on the basis of western medicine treatment group,and 6 weeks was a course of treatment.The clinical efficacy and Traditional Chinese Medicine(TCM)syndrome scores were compared between the two groups of patients after treatment,and the changes in humoral immune indexes,biochemical,and liver and kidney functions of the patients before and after treatment were analyzed.Results The total effective rate was 100.00%(84/84)in the integrated treatment group and 97.65%(83/85)in the western medicine treatment group.The difference was not statistically significant(P>0.05).The difference was not statistically significant(P>0.05).There was no statistically significant difference in TCM syndrome scores between the two groups before treatment(P>0.05),and the TCM syndrome scores after treatment were lower than before treatment(P<0.05).Among them,the TCM syndrome scores of the integrated treatment group were lower than those of the western medicine treatment group(P<0.05).There was no significant difference in IgG,IgA,IgM,C3,C4,miRNA-155,C-reactive protein(CRP),erythrocyte sedimention rate(ESR),alanine aminotransferase(ALT)and aspartate aminotransferase(AST)between the two groups before treatment(P>0.05).After treatment,IgG,IgA,IgM,miRNA-155,CRP,ESR,ALT and AST were all lower than before treatment,and C3 and C4 complement levels were higher than before treatment(P<0.05).Among them,IgG,IgA,IgM,miRNA-155,CRP,ESR,ALT and AST in the integrative treatment group were all lower than the western medicine treatment group,while the C3 and C4 complement levels were higher than the western medicine treatment group(P<0.05).Conclusion The treatment of brucellosis with integrated traditional Chinese and western medicine can significantly improve the TCM syndrome score and reduce the levels of CRP and ESR.The mechanism of action may be related to the regulation of the patient's humoral immunological indicators.